Establishment of the reference intervals of thyroid function for children in Shanghai

doi:10.3969/j.issn.1673-8640.2016.12.008

Abstract

Abstract:

Objective To establish the reference intervals of thyroid stimulating hormone（TSH）,free triiodothyronine（FT₃） and free thyroxine（FT₄） for children in Shanghai.Methods A total of 720 healthy children of 4 d to 17 years old from 9 hospitals in Shanghai were enrolled from August 2014 to July 2015. These children were classified into 6 groups according to ages and 120 cases were in each group. After centrifugation,serum specimens were frozen at -20 ℃. The levels of TSH,FT₃ and FT₄were determined by Beckman Coulter DxI 800 automated immunoassay system. The reference intervals of TSH,FT₃ and FT₄ were established according to the Clinical and Laboratory Standards Institute（CLSI） C28-A3 and the International Federation of Clinical Chemistry and Laboratory Medicine（IFCC） guidelines. Nonparametric methods were used to establish the 2.5th and 97.5th percentiles for reference intervals and 90% confidence interval. Results The ages of Group A-F were 4 d -<1 month,1-<12 months,1-<5 years,5-<10 years,10-<14 years and 14-17 years,respectively. The reference intervals of Group A were TSH 0.53-18.91 μIU/mL,FT₃ 2.42-5.67 pmol/L and FT₄ 11.85-33.81 pmol/L. The reference intervals of Group B were TSH 0.75-5.75 μIU/mL,FT₃ 4.21-8.16 pmol/L and FT₄ 9.40-19.54 pmol/L. The reference intervals of Group C were TSH 0.63-6.20 μIU/mL,FT₃ 3.54-6.90 pmol/L and FT₄ 9.32-18.40 pmol/L. The reference intervals of Group D were TSH 0.58-5.39 μIU/mL,FT₃ 3.97-7.83 pmol/L and FT₄ 10.65-19.23 pmol/L. The reference intervals of Group E were TSH 0.39-5.36 μIU/mL,FT₃ 4.27-8.55 pmol/L and FT₄ 9.80-19.64 pmol/L. The reference intervals of Group F were TSH 0.48-5.06 μIU/mL,FT₃ 3.14-6.15 pmol/L and FT₄ 9.57-18.27 pmol/L. There was statistical significance for reference interval distribution between Group A and B（Z>3）. The TSH,FT₃ and FT₄ reference intervals for sex in all age groups showed no statistical significance（P>0.05）. Conclusions The reference intervals of TSH,FT₃ and FT₄ are established for healthy children of 4 d to 17 years old in Shanghai. The reference intervals above can explain the results of thyroid function,which can improve the diagnosis,treatment and monitoring of hypothyroidism,hyperthyroidism,thyroiditis,goiter and thyroid neoplasm for children.

Key words: Thyroid stimulating hormone, Free triiodothyronine, Free thyroxine, Reference intervals, Children

CLC Number:

R446.62

LI Huaiyuan, JIANG Limin, QIAN Yueping, FU Qihua, LI Dong. Establishment of the reference intervals of thyroid function for children in Shanghai[J]. Laboratory Medicine, 2016, 31(12): 1045-1049.

Figures/Tables 6

References 11

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项目	低值血清			高值血清
项目	x	s	CV（%）	x	s	CV（%）
TSH （μIU/mL）	0.63	0.03	4.76	7.14	0.29	4.06
FT₄（pmol/L）	9.74	0.34	3.49	26.93	0.75	2.78
FT₃（pmol/L）	3.86	0.12	3.11	10.45	0.43	4.11

项目	低值血清			高值血清
项目	x	s	CV（%）	x	s	CV（%）
TSH （μIU/mL）	0.63	0.03	4.76	7.14	0.29	4.06
FT₄（pmol/L）	9.74	0.34	3.49	26.93	0.75	2.78
FT₃（pmol/L）	3.86	0.12	3.11	10.45	0.43	4.11

项目	低值血清			高值血清
项目	x	s	CV（%）	x	s	CV（%）
TSH （μIU/mL）	1.15	0.04	3.48	11.78	0.34	2.89
FT₄（pmol/L）	8.85	0.36	4.07	35.67	1.21	3.39
FT₃（pmol/L）	2.82	0.11	3.90	22.82	0.68	2.98

项目	低值血清			高值血清
项目	x	s	CV（%）	x	s	CV（%）
TSH （μIU/mL）	1.15	0.04	3.48	11.78	0.34	2.89
FT₄（pmol/L）	8.85	0.36	4.07	35.67	1.21	3.39
FT₃（pmol/L）	2.82	0.11	3.90	22.82	0.68	2.98

组别	年龄	例数	TSH（μIU/mL）			Z值
组别	年龄	例数	P₅₀	P_2.5	P_97.5	Z值
A组	4 d~<1个月	120	4.47	0.53	18.91
B组	1~<12个月	120	2.19	0.75	5.75	Z_A、B=7.79
C组	1~<5岁	120	2.10	0.63	6.20	Z_B、C=0.18
D组	5~<9岁	120	2.14	0.58	5.39	Z_C、D=0.19
E组	9~<14岁	120	2.10	0.39	5.36	Z_D、E=0.48
F组	14~17岁	120	1.82	0.48	5.06	Z_E、F=0.64